Active NPI
Pompton Lakes Pulmonary, P.C.
- Pulmonary Disease Physician
- Lincoln Park, NJ
National Provider Identifier
1568417210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- Legal business name
- POMPTON LAKES PULMONARY, P.C.
- Practice address
- 63 Beaverbrook Rd Ste 301
Lincoln Park, NJ 07035-1440 - Phone
- (973) 694-1300
- Fax
- (973) 694-1399
- NPI assigned
- May 23, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Timothy O'Donnell, D.O.
- Title
- President
- Phone
- (973) 694-1300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | Primary |
Addresses
Primary practice location
63 Beaverbrook Rd Ste 301
Lincoln Park, NJ 07035-1440
Mailing address
63 Beaverbrook Rd Ste 301
Lincoln Park, NJ 07035-1440
Phone (973) 694-1300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6836101 | Medicaid | NJ |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pulmonary Disease Physician
- Englewood Cliffs, NJ
- NPI 1609806694
-
- Pulmonary Disease Physician
- Clifton, NJ
- NPI 1881703726
-
- Pulmonary Disease Physician
- Wayne, NJ
- NPI 1447336771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208649600000",
"number": "1568417210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 BEAVERBROOK RD STE 301",
"city": "LINCOLN PARK",
"state": "NJ",
"postal_code": "070351440",
"telephone_number": "973-694-1300",
"fax_number": "973-694-1399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 BEAVERBROOK RD STE 301",
"city": "LINCOLN PARK",
"state": "NJ",
"postal_code": "070351440",
"telephone_number": "973-694-1300",
"fax_number": "973-694-1399"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "POMPTON LAKES PULMONARY, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-23",
"last_updated": "2008-04-20",
"status": "A",
"authorized_official_last_name": "O'DONNELL",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "973-694-1300",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Pulmonary Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6836101",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lincoln Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.